The younger son of Tsar Alexis (reigned 1645–76) by his first wife, Mariya Ilinichna Miloslavskaya, Ivan was a chronic invalid, deficient mentally and physically, who suffered from scurvy and poor eyesight and in his later years was partially paralyzed. When his elder brother Tsar Fyodor III died in 1682, Ivan’s half brother Peter, the son of Alexis and his second wife, Natalya Kirillovna Naryshkina, was named tsar. But Ivan’s sister Sophia, determined to maintain the Miloslavsky family in power, encouraged the streltsy (sovereign’s bodyguard) to riot and to demand that Ivan become tsar (May 23 [June 2], 1682). Consequently, three days later the boyar duma (or council) proclaimed Ivan and Peter corulers with Ivan as the senior tsar. On June 25 (July 5) both boys were crowned, and Sophia became regent.

Although the Naryshkins overthrew Sophia in 1689, Ivan, who had adopted a conciliatory attitude toward Peter, was allowed to retain his official position until his death. He never participated in governmental affairs, however, and devoted the bulk of his time to prayer, fasting, and pilgrimages.